Onco Wiki / Droga

Ifosfamide

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IDDRUG-IFOSFAMIDE
TipoFármaco
Alegais
HoloxanIfexMitoxanaІфосфамід
Estadoreviewed 2026-04-26 | pending_clinical_signoff
DoençasDIS-BURKITT DIS-EATL DIS-HSTCL DIS-MPNST DIS-NK-T-NASAL DIS-PENILE-SCC DIS-PMBCL DIS-SOFT-TISSUE-SARCOMA DIS-TESTICULAR-GCT
FontesSRC-NCCN-BCELL-2025

Fatos sobre as drogas

Classealkylating_agent — oxazaphosphorine (nitrogen mustard analog)
MecanismoProdrug requiring hepatic CYP3A4 / CYP2B6 activation to 4-hydroxy- ifosfamide, which decomposes to ifosforamide mustard — the active DNA- alkylating species producing N7-guanine inter-strand crosslinks and apoptosis in proliferating cells. Side-chain oxidation also generates acrolein (urotoxic — drives hemorrhagic cystitis, neutralized by mesna) and chloroacetaldehyde (the principal neurotoxic metabolite responsible for ifosfamide-induced encephalopathy).
Dose típicaICE / RICE (R/R DLBCL pre-ASCT): 5000 mg/m² IV continuous infusion over 24 h on day 2, with mesna co-administered at 5000 mg/m² in the same bag + 2500 mg/m² infused over 12 h after end of ifosfamide. CODOX-M / IVAC (Burkitt): 1500 mg/m² IV days 1-5 with mesna. ICE pediatric (sarcoma / Wilms): 1800 mg/m² IV days 1-5 with mesna 360 mg/m² before and at 4 + 8 h after each dose. Single-agent germ-cell salvage: 1200 mg/m² IV days 1-5 with mesna.
Ucrânia registadaVerdade
NSZU reembolsadoVerdade
Ucrânia verificada pela última vez2026-04-27

Avisos

Notas

Mesna mandatory at 60-160% of ifosfamide dose in divided schedule (at 0, 4, 8 h after each ifosfamide dose, or in the same bag for continuous infusions). Aggressive hydration (2-3 L/day during therapy) plus daily urine dipstick for blood. Risk factors for encephalopathy: hypoalbuminemia (<3.5 g/dL), elevated creatinine, prior cisplatin exposure, low bicarbonate, pelvic disease bulk. Standard ICE includes G-CSF support starting day 5; >80% of R/R DLBCL patients receive ASCT mobilization with this regimen.

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